Nearly 9,000 Canadians are diagnosed with bladder cancer every year. Here’s what you need to know

Senator David Tkachuk was first diagnosed with bladder cancer in 2012, and has been cancer-free for about four years. Here’s what he wants people to know about the disease.

For Senator David Tkachuk, the news that he had bladder cancer was “devastating.”

Hearing the word “cancer” made him, “Totally scared. Panic,” he said.

He had noticed a problem in 2012, when he saw blood in his urine. “I saw red, and I went to see the doctor right away. He referred me to a urologist, we did a test and found out that there was a tumour.”

He received an operation within about two weeks, but it wasn’t over.

“It came back. It was pre-cancerous at first but it came back. Most bladder cancers do.”

After that, he went on an immunotherapy treatment for a few years. “And now I’m off it and I’m just getting tested. It was a positive experience for me to date, but with bladder cancer, it’s never over.”

Bladder cancer is Canada’s fifth most common cancer, with nearly 9,000 cases diagnosed every year.

May is Bladder Cancer Awareness Month, and here’s what you need to know about the disease.

Who does it affect?

The older a patient is, the more at risk they are of developing bladder cancer, said Dr. Peter Black, a urologist at Vancouver General Hospital and professor at the University of British Columbia.

“The average age of the bladder cancer patient is higher than any other cancer,” he said.

Smoking is also a major risk factor, and one that Tkachuk – a former smoker – had. “If I knew that smoking causes bladder cancer, I would have paid more attention beforehand,” he said.

It’s also much more common among men than women – to the point that it often takes longer for a woman to get diagnosed. “If a woman has blood in her urine, it’s often attributed to a urinary tract infection rather than being evaluated properly,” said Black. “And that can lead to a delay and potentially to a worse outcome, so it’s particularly important that women be thinking of bladder cancer as a possibility.”

What are the signs?

The biggest sign of bladder cancer, by far, is blood in your urine. “Either they see blood, or it’s picked up on a routine urine test. That’s about 90 per cent of patients,” said Black. “A small minority will just have symptoms, such as going to the bathroom more often and going more urgently.”

So if you see blood in your urine, you need to be evaluated for bladder cancer, he said.

How treatable is it?

Much of the bladder cancer out there is “very treatable” according to Black. For non-invasive forms of the disease, the treatment often involves surgery to remove tumours from the surface of the bladder.

Tkachuk didn’t find his two surgeries to be too bad. “The surgeries, they’re not that painful, they’re not that difficult, because I wasn’t removing a bladder, I was just removing a tumour,” he said.

“During the treatment, I went to work. I didn’t give up my gym time. I didn’t give up my holidays. I just operated life and enjoyed it.”

About one-quarter of bladder cancer cases are invasive, said Black, and require more intensive treatment, such as chemotherapy drugs.

“It’s very important to catch it early,” said Black. “The higher-risk tumours and the invasive ones will progress to something worse relatively quickly. So we know that early detection is very important to give the best outcomes.”

New innovations in treatment, like a fluorescent dye that makes the tumours “light up nice and pink on a blue background” for easy removal, and advances in immunotherapy drugs, have helped to improve treatment over the last few years, said Black.

Tkachuk says he would tell someone who is diagnosed, “That there are a lot of treatment options. That there’s no reason to lose hope.”

It comes back

Bladder cancer has an unusually high recurrence rate – about 60 to 70 per cent, according to Bladder Cancer Canada. This makes it very expensive to treat, simply because multiple treatments and constant monitoring are required.

“I am a recovering bladder cancer patient. That’s what I am and that’s what I will be the rest of my life,” said Tkachuk. He still regularly gets checkups to make sure the cancer hasn’t returned again.

Despite this, he stays positive.

“I am a positive person. I think most people who survive cancer and go through it and are surviving are the same.”

“They understand it’s a scary thing. It’s deadly so it’s a scary thing. And you’re just happy you survived and enjoy every day probably more than you did before for sure.”